DEFINITION

Handwashing is the vigorous rubbing of previously soaped hands, followed by rinsing with abundant water, in order to remove dirt, organic matter, transient and resident flora, and thus prevent the transmission of these microorganisms from person to person .

The use of alcoholic solutions for handwashing is an alternative to take seriously into account in hand hygiene today (further development in another chapter).

Resident flora: also called colonizer. They are microorganisms that are usually found in the skin. They are not easily removed by mechanical friction.

Transient flora: also called pollutant or “non-colonizing”. They are microorganisms that contaminate the skin, not usually found in it. Its importance lies in the ease with which they are transmitted, being the origin of most nosocomial infections.

TYPES OF HAND WASHING

HYGIENIC ROUTINE WASHING

Objective:
Remove dirt, organic matter and transient flora from the hands.

Material:
Ordinary liquid soap, in disposable dispenser, with dispenser.
Disposable paper towel.

Technique:
Moisten hands with running water, preferably warm.
Apply liquid soap with dispenser.
Rub hands palm to palm, on backs, interdigital spaces and wrists for at least 10 minutes.
Rinse with plenty of running water.
Dry hands with paper towels.
Close the faucet with the paper towel used for drying (the washbasins with elbow or pedal closure system save this step; the photoelectric cell, in addition, determine a significant water saving).

Indications:
Before and after contact with each patient.
Between two procedures in the same patient if there is suspicion of contamination of the hands.
After contact with any source of microorganisms (substances and body fluids, mucous membranes not intact …) and objects contaminated with dirt.
After removing gloves.

SPECIAL OR ANTISEPTIC WASH

Objective:
Remove dirt, organic matter and transient flora and part of the resident flora of the hands, also achieving some residual microbial activity.

Material:
Liquid soap with antiseptic (4% chlorhexidine soap solution or 7.5% povidone iodine), in disposable dispenser, with dispenser. Disposable paper towel.

Technique:
Same as in hygienic washing. Just change the type of soap.

Indications:
Before performing invasive procedures such as catheter insertion, bladder catheters.
Before and after contact with patients known or suspected they are infected or colonized by epidemiologically important microorganisms.

Before contact with immunocompromised patients in situations of well-founded risk of transmission.

SURGICAL WASH

Objective:
Eliminate the transient flora and the maximum resident flora of the hands prior to an invasive procedure that, due to its specificity or duration, requires a high degree of asepsis and a residual effect.

Material:
Liquid soap with antiseptic (soapy solution of chlorhexidine or povidone iodine), in disposable dispenser, with dispenser.
Disposable nail brush (preferably impregnated in antiseptic solution).
Towel or sterile compress.

Technique:
Open the tap (only washbasins with elbow or pedal system).
Apply antiseptic soap.
Mechanical hand and forearm wash and clean under the nails with a disposable brush.
Rinse with plenty of running water.
Apply again antiseptic soap on hands and forearms rubbing at least 2 MINUTES.
Rinse with plenty of water.
Dry by application, without rubbing, with a sterile disposable towel or compress, starting with the fingers and down to the elbows.
Throughout the process, keep your hands above your elbows.

Indications:
Before a surgical intervention.
Before any invasive maneuver that requires a high degree of asepsis.

RECOMMENDATIONS

Keep nails short and clean. Long nails are more difficult to clean and increase the risk of breaking gloves. Do not wear artificial nails.

Do not wear rings, watches, or bracelets. These elements can act as a reservoir and make it difficult to clean hands and forearms.

The use of emollients and protective skin lotions, after work activity, is considered desirable and even recommended in daily practice, because they can increase the resistance of the skin to germs and, therefore, reduce cross infection. However, it must be taken into account that some antiseptics are inactivated in the presence of some of these products.

DEFINITION

Hygiene measure consisting in the elimination by dragging of the flora present temporarily in the skin of the hands. It is considered one of the most effective measures in the prevention and control of disease transmission in